GULU UNIVERSITY MEDICAL JOURNAL

Gulu University Medical Journal (GUMJ) 2009/2010 Vol 5.
whose semester started before the end of the course, and
for international students, some of whom had difficulty
completing internship interviews in the US before the
course began. Students from Gulu University faced
accommodation and transportation difficulties because
of the course location at Lacor Hospital. The need for
many Ugandan students to commute between Lacor
and Gulu town made it difficult for Ugandan students
to consistently arrive on time in the morning and
prevented some of them from staying for evening film
showings. Finally, significant challenges were faced in
trying to raise enough funding to pay for the course.
We met limited success in our efforts to secure funding
from NGOs, foundations, and involved universities.
The Way Forward
Given the great success of this year’s course, the social
medicine course will again be offered from January 10
– February 4, 2011 and all Gulu University students
will be welcome to apply. In July 2010, SEHC plans to
do extensive publicity to encourage applications. This
year’s course participants also plan to share the lessons
learnt from this course through film screenings and
discussions open to all members of the Gulu University
Faculty of Medicine. Furthermore, these students will
continue to work on advocacy and research projects
related to drug stockouts and malnutrition, which
have began as a result of the course.
In order to enhance next year’s course, efforts will be
made to find accommodation for Ugandan students
near Lacor Hospital for the full duration of the course.
Intensified efforts to find creative sources of funding
for the course will be made. These efforts will include
asking Gulu University to extend financial support for
subsequent years given the great benefit of the course
for its students and the surrounding community.
Conclusion
The social medicine course provided the opportunity for
an intensive study of the social determinants of health.
Together, students from around the world, developed
a map of these determinants of health in northern
Uganda. Gender inequality, minimal educational
opportunities, poverty, unemployment, food insecurity,
political instability, racism, and unequal global trade
and exploitation were factors identified as significant
contributors to the epidemiology of disease.
These themes are intricately linked in both simple and
complicated ways to this issue’s theme of maternal
and child morbidity and mortality. Tracing these
linkages reveals that gender inequality often results
in men accessing the best nutrition, opportunities for
education, and opportunities to have their voices heard.
Meanwhile, too often women and children are left with
inadequate nutrition, poor educational opportunities,
and a near silencing of their perspectives. Genderbased
violence leads to physical abuse of women in an
environment that dismisses their concerns. In settings
of extreme poverty, women turn to transactional sex for
survival, putting themselves at great risk of HIV/AIDS.
Inadequate water and sanitation contributes to excess
disease amongst children who play in contaminated
areas and drink unpurified water. Such social factors
clearly worsen the health of women and children.
Women and children are not only at greater risk of
disease but have difficulty accessing adequate health
services. Frail health systems are unable to provide
proper prenatal and gynecological care. Mosquito
nets, a central tool in malaria prevention, are often too
expensive for families. Health centers in rural areas are
often understaffed and lack the necessary medicines.
Thereby, the common and treatable diseases of children
and women, such as helminthiasis, uncomplicated
malaria, mild malnutrition, respiratory tract infections,
and complications associated with delivery, are not
properly addressed in the community at early stages
and become serious medical problems.
We can likely all agree that some of these social factors
identified above have a negative impact upon the health
of women and children. But, then, we might ask, why
do these factors continue to preferentially contribute to a
heavy burden of disease amongst women and children?
Analysis through the lens of social medicine reveals
that these circumstances are very often shaped by the
distribution of money, power and resources at global,
national and local levels in ways that disadvantage the
health of women and children. Thus, we must remind
ourselves to continually ask, “Why treat mothers and
children without changing what makes them sick?”
Gulu University Medical Students’ Association (GUMSA) Passion for life 28